<%--
  Created by IntelliJ IDEA.
  User: SoulWolf
  Date: 2017/7/16
  Time: 21:33
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--%>
<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<%@taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core" %>
<%@ taglib uri="http://java.sun.com/jsp/jstl/fmt" prefix="fmt" %>
<!DOCTYPE html>
<html lang="zh-CN">
<head>
    <jsp:include page="../head.jsp" flush="true">
        <jsp:param name="title" value="后台管理系统 - 用户管理"/>
    </jsp:include>
    <style>
        td{width:100px;heitht:auto;}
        table{text-align:center;}
        p{width:1000px;}
        input{width:100px;border:none;}
    </style>
    <script type="text/javascript">
        function checkForm() {
            if (window.confirm("确定提交表格并进入下一表格吗？\r\注意：表格不可重复填写！")) {
                return true;
            }
            return false;
        }
    </script>
</head>
<body  align="center">
<!-- 头导航 -->
<jsp:include page="../navbar.jsp"/>

<form action="${domain}/admin/seventh/e" method="post"  onsubmit="return checkForm()">
    <div align="center" width="1000px">
        <td><input name="oName" type="hidden" value="${oName}"></td>

        <h4>表6  2016年自费疫苗情况调查表</h4>

        <table border="1" cellspacing="0" cellpadding="0">
            <tr>
                <td >疫苗名称</td>
                <td>品规</td>
                <td>本机构接种数量（人次）</td>
                <td>接种单价（元/支）</td>
                <td>下发数量（支）</td>
                <td>下发单价（元/支）</td>
            </tr>
            <%
                String[]  value  = { "甲肝疫苗","乙肝疫苗","乙脑疫苗","狂犬疫苗",
                        "流腮疫苗","HIB疫苗","23价肺炎疫苗",
                        "水痘疫苗","轮状疫苗", "IPV活脊灰疫苗","流感疫苗"};
                pageContext.setAttribute("value", value);
            %>
            <c:forEach var="s"  begin="0" end="24">
                <tr>
                    <c:choose>
                        <c:when test="${s<11}">
                            <td><input name=seventhE[${s*6+0}] value="${pageScope.value[s]}" type="hidden">${pageScope.value[s]}</td>
                        </c:when>
                        <c:otherwise>
                            <td><input name=seventhE[${s*6+0}] ></td>
                        </c:otherwise>
                    </c:choose>
                    <td><input name=seventhE[${s*6+1}] ></td>
                    <td><input name=seventhE[${s*6+2}] type="number" step="0.01" ></td>
                    <td><input name=seventhE[${s*6+3}] type="number" step="0.01"></td>
                    <td><input name=seventhE[${s*6+4}] type="number" step="0.01"></td>
                    <td><input name=seventhE[${s*6+5}] type="number" step="0.01"></td>
                </tr>
            </c:forEach>
            <c:forEach var="h"  begin="0" end="35">
                <tr>
                <td><input name=seventhEo[${h*6+0}] ></td>
                <td><input name=seventhEo[${h*6+1}] ></td>
                <td><input name=seventhEo[${h*6+2}] type="number" step="0.01" ></td>
                <td><input name=seventhEo[${h*6+3}] type="number" step="0.01"></td>
                <td><input name=seventhEo[${h*6+4}] type="number" step="0.01"></td>
                <td><input name=seventhEo[${h*6+5}] type="number" step="0.01"></td>
                </tr>
            </c:forEach>
            <c:forEach var="h"  begin="0" end="29">
                <tr>
                    <td><input name=seventhEp[${h*6+0}] ></td>
                    <td><input name=seventhEp[${h*6+1}] ></td>
                    <td><input name=seventhEp[${h*6+2}] type="number" step="0.01" ></td>
                    <td><input name=seventhEp[${h*6+3}] type="number" step="0.01"></td>
                    <td><input name=seventhEp[${h*6+4}] type="number" step="0.01"></td>
                    <td><input name=seventhEp[${h*6+5}] type="number" step="0.01"></td>
                </tr>
            </c:forEach>
        </table>
        <p align="left">
            注：</br>
            1、疫苗范围包括免疫规划内收费疫苗与计划外疫苗，同一疫苗涉及多个剂型、厂商的，可作为不同品规分别填报。</br>
            2、接种单价包括接种费和疫苗费。</br>
            3、如本机构无某一疫苗的接种，请在对应的单元格中填“0”。</br>
            4、表中没有列出的疫苗，请在空行中补充。</br>
        </p>
    <button type="submit" ><b>提交并进入下一表格</b></button>


    </div>

</form>
</body>
</html>